Helou B, Bel-Brunon A, Dupont C, Ye W, Silvestro C, Rochette M, Lucas A, Kaladji A, Haigron P
Annu Int Conf IEEE Eng Med Biol Soc. 2020 Jul;2020:2536-2539. doi: 10.1109/EMBC44109.2020.9176740.
Atherosclerosis is one of the most common vascular pathologies in the world. Among the most commonly performed endovascular treatments, percutaneous transluminal angioplasty (PTA) has been showing significantly positive clinical outcomes. Due to the complex geometries, material properties and interactions that characterize PTA procedures, finite element analyses of acute angioplasty balloon deployment are limited. In this work, finite element method (FEM) was used to simulate the inflation and deflation of a semi-compliant balloon within the 3D model of a stenosed artery with two different plaque types (lipid and calcified). Self-defined constitutive models for the balloon and the plaque were developed based on experimental and literature data respectively. Balloon deployment was simulated at three different inflation pressures (10, 12 and 14 atm) within the two plaque types. Balloon sizing influence on the arterial elastic recoil obtained immediately after PTA was then investigated. The simulated results show that calcified plaques may lead to higher elastic recoil ratios compared to lipid stenosis, when the same balloon inflation pressures are applied. Also, elastic recoil increases for higher balloon inflation pressure independent of the plaque type. These findings open the way for a data-driven assessment of angioplasty balloon sizing selection and clinical procedures optimization.Clinical Relevance- The FE model developed in this work aims at providing quantitative evaluation of recoil after balloon angioplasty. It may be useful for both manufacturers and clinicians to improve efficiency of angioplasty balloon device design and sizing selection with respect to plaque geometry and constitution, consequently enhancing clinical outcomes.
动脉粥样硬化是世界上最常见的血管病变之一。在最常用的血管内治疗方法中，经皮腔内血管成形术（PTA）已显示出显著的积极临床效果。由于PTA手术具有复杂的几何形状、材料特性和相互作用，急性血管成形术球囊扩张的有限元分析受到限制。在这项工作中，采用有限元方法（FEM）模拟了在具有两种不同斑块类型（脂质和钙化）的狭窄动脉三维模型中半顺应性球囊的膨胀和收缩。分别基于实验和文献数据建立了球囊和斑块的自定义本构模型。在两种斑块类型中，在三种不同的膨胀压力（10、12和14个大气压）下模拟球囊扩张。然后研究了球囊尺寸对PTA后立即获得的动脉弹性回缩的影响。模拟结果表明，在施加相同的球囊膨胀压力时，钙化斑块可能比脂质狭窄导致更高的弹性回缩率。此外，无论斑块类型如何，较高的球囊膨胀压力都会增加弹性回缩。这些发现为基于数据的血管成形术球囊尺寸选择评估和临床手术优化开辟了道路。临床相关性——本工作中开发的有限元模型旨在对球囊血管成形术后的回缩进行定量评估。对于制造商和临床医生来说，根据斑块的几何形状和构成来提高血管成形术球囊装置设计和尺寸选择的效率，从而提高临床效果，可能会有所帮助。
